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Active
Organization subpart
No

Provider details

NPI number
Authorized official
SONJIA MCVAY (FISCAL DIRECTOR)
(985) 350-1446
Entity
Organization

Contact information

Practice address
1665 SW RAILROAD AVE, SUITE 6, HAMMOND, LA 70403-6133
(985) 350-1446
Mailing address
PO BOX 2907, HAMMOND, LA 70404-2907
(985) 350-1446

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1351211
LA
Enumeration date
05/04/2007
Last updated
08/08/2007
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